Active NPI
Andrea Kahealani Stanley, RT (R)(M)
- Registered Nurse
- Jbphh, HI
National Provider Identifier
1639792633
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 463602
- Practice address
- 480 Central Ave
Jbphh, HI 96860-4908 - Phone
- (808) 473-1880
- NPI assigned
- May 26, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 463602 | NV | Primary |
Addresses
Primary practice location
480 Central Ave
Jbphh, HI 96860-4908
Mailing address
5716 Bullhead St
North Las Vegas, NV 89031-4240
Phone (702) 509-0745
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 463602 | NV | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1590451200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1590451200000",
"number": "1639792633",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5716 BULLHEAD ST",
"city": "NORTH LAS VEGAS",
"state": "NV",
"postal_code": "890314240",
"telephone_number": "702-509-0745"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "480 CENTRAL AVE",
"city": "JBPHH",
"state": "HI",
"postal_code": "968604908",
"telephone_number": "808-473-1880"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STANLEY",
"first_name": "ANDREA",
"middle_name": "KAHEALANI",
"name_prefix": "Miss",
"credential": "RT (R)(M)",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-05-26",
"last_updated": "2020-05-26",
"certification_date": "2020-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NV",
"license": "463602",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jbphh, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.